This Post will be updated as new-information arises
Hospital Non-Invasive Machines can be Adapted for Invasive Ventilation
Most machines are single tube circuits that allow exhalation from a vented mask. If hooked up to an ETT, you need an exhalation port and it must be proximal to a viral filter. Many of the companies sell circuits purpose-built for this, for example:
If not, items can be adapted to this use by Respiratory Therapy. Key is anything venting to the environment is filtered
Home BiPAP/CPAP Machines
- Same deal as above
- Sinai's Research Page on Adapting Home CPAP Machines
- Adapting the V60
Many chronically vented patients have their primary ventilator and a back-up in their homes. If they want to help, their community, a loan of these back-up ventilators would be helpful.
Oxygen Powered Commercial CPAP Devices
and similar devices
See the EMCrit Post
With a PEEP cap in place, these will replace a ventilator
EMCrit CPAP Set-Up
can be used for invasive CPAP through an ETT for patients who are awake and spontaneously breathing freeing up the ICU ventilators for patients requiring mandatory breaths.
see video describing set-up on EMCrit COVID Airway Post
This will not be as comfortable as a legit machine, but it should get the job done
Garbage Disaster Vents
Splitting Non-Invasive CPAP
Listen to the Wee below for more on this…
Should work on invasive CPAP as well
This seems absolutely a last resort situation. SCCM has released a guidance document saying the same:
- SCCM Statement on Vent Splitting
- PULMCrit Retort to the SCCM Statement
- Read Jack Iwashyna take on the issue
- Columbia White Paper
If it has to be done, there are a number of sources for info on the FOAMverse. Josh released his thoughts in his PULMcrit Post.
Additional Vent Splitting Resources
And this one from Illinois
On to the Wee with Marco Garrone
Marco is an EM Doc in Turin, Italy. They are fully in the surge and have split vents for NIPPV.